Objective: The rate of symptomatic adjacent-segment disease (ASD) after newer minimally invasive techniques, such as lateral lumbar interbody fusion (LLIF), is not known. This study aimed to assess the incidence of surgically significant ASD in adult patients who have undergone index LLIF and to identify any predictive factors.
Methods: Patients who underwent index LLIF with or without additional posterior pedicle screw fixation between 2010 and 2012 and received a minimum of 2 years of postoperative follow-up were retrospectively included. Demographic and perioperative data were recorded, as well as radiographic data and immediate perioperative complications. The primary endpoint was revision surgery at the level above or below the previous construct, from which a survivorship model of patients with surgically significant symptomatic ASD was created.
Results: Sixty-seven patients with a total of 163 interbody levels were included in this analysis. In total, 17 (25.4%) patients developed surgically significant ASD and required additional surgery, with a mean ± SD time to revision of 3.59 ± 2.55 years. The mean annual rate of surgically significant ASD was 3.49% over 7.27 years, which was the average follow-up. One-third of patients developed significant disease within 2 years of index surgery, and 1 patient required surgery at the adjacent level within 1 year. Constructs spanning 3 or fewer interbody levels were significantly associated with increased risk of surgically significant ASD; however, instrument termination at the thoracolumbar junction did not increase this risk. Surgically significant ASD was not impacted by preoperative disc height, foraminal area at the adjacent levels, or changes in global or segmental lumbar lordosis.
Conclusions: The risk of surgically significant ASD after LLIF was similar to the previously reported rates of other minimally invasive spine procedures. Patients with shorter constructs had higher rates of subsequent ASD.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.3171/2020.10.SPINE201635 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Comparing adjacent segment biomechanics between anterior and posterior cervical fusion using patient-specific finite element modeling.
Asian Spine J
December 2024
Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA.
Study Design: This study employed a patient-specific finite element model.
Purpose: To quantify the effect of anterior and posterior surgical approaches on adjacent segment biomechanics of the patient-specific spine and spinal cord.
Overview Of Literature: Adjacent segment degeneration (ASD) is a well-documented complication following cervical fusion, typically resulting from accelerated osteoligamentous deterioration and subsequent symptomatic neural compression.
Outcome and safety 90 days after combined airway valve treatment of the right upper and middle lobes in patients with severe pulmonary emphysema.
Respir Res
January 2025
Department of Pneumology and Critical Care Medicine, Thoraxklinik at the University Hospital Heidelberg, Heidelberg, Germany.
Background: In COPD patients with severe right-sided emphysema, complete major and incomplete minor fissure, implantation of one-way valves in both the right upper (RUL) and middle lobes (ML) is a possible approach for endoscopic lung volume reduction. The aim of this retrospective analysis was to evaluate the response to therapy and the complication rate at 90 days (90d-FU) after combined RUL-ML valve implantation.
Methods: This retrospective, monocentric study included all patients from the Thoraxklinik Heidelberg who underwent RUL-ML valve treatment between 2012 and 2023 with available follow-up data.
The Role of Robotics in Cardiac Surgery: Innovations, Outcomes, and Future Prospects.
Cureus
November 2024
Internal Medicine, Nishtar Medical University, Multan, PAK.
In recent years, there has been a notable increase in the use of robotic technology in medical surgery, especially in heart surgery. Many advancements in surgery have been made possible by the development of these robotic devices, such as the da Vinci surgical system (Intuitive Surgical, Sunnyvale, California, United States). These advancements include improved ergonomics, three-dimensional (3D) imaging, and increased dexterity.
View Article and Find Full Text PDFDevelopmental Psychology and Healthcare Professions: Autism Knowledge Among Nurses: An Observational Study.
Clin Pract
December 2024
Department of Humanistic Studies, University of Naples Federico II, 80126 Naples, Italy.
One of the biggest limitations faced by autistic people is the lack of knowledge of their condition. Our study aims to evaluate and discuss the knowledge of autism among nurses, which is a social and health category often in close contact with autistic people. Given the limited exploration of awareness levels about autism among healthcare professionals, this study aims to investigate general and specific knowledge of autism within a group of nursing students enrolled in a master's degree.
View Article and Find Full Text PDFEvaluation of short-term consequences of atrial septal defect closure in adults referred to Shahid Chamran heart center in Isfahan.
ARYA Atheroscler
January 2024
Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Background: Secundum Atrial Septal Defects (ASDs) are the most common type of atrial septal defects. Today, using different types of occluders, transcatheter closure is widely used to treat ASD and has replaced the surgical procedure in anatomically suitable patients. This study was performed to evaluate the short-term clinical outcomes of treatment of adult patients requiring an ASD device closure referred to Shahid Chamran Cardiovascular Center in Isfahan, Iran.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!